Vickas Khemsara, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

01566 Issued in NC

Practice address

1710 South Hawthorne Rd
Summit Eye Care
Winston Salem, NC 27103-4016

Phone

(336) 765-0960

Fax

(336) 765-7453

NPI assigned

Jun 10, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Texas Tech University Health Science Center School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Eye Care PAGroup PAC ID 9133270283, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

100

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Summit Eye Care, P.a.

  • Ophthalmology Physician
  • Winston Salem, NC
  • NPI 1992932016
  Medicare reassignment Care Compare group NPD Authorized official
• Pinnacle Eye Care PA

  • Ophthalmology Physician
  • Winston Salem, NC
  • NPI 1609024165
  NPD (past) Authorized official
• Summit Eye Care, PA

  • Optician
  • Winston Salem, NC
  • NPI 1639276835
  NPD (past) Authorized official
• Campbell Cunningham Taylor PC

  • Optometrist
  • Knoxville, TN
  • NPI 1407850944
  NPD (past)
• Ecsc II PA

  • Specialist
  • Dallas, TX
  • NPI 1184733362

  Ophthalmology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1477557023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 S HAWTHORNE RD",
            "address_2": "SUMMIT EYE CARE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034016",
            "telephone_number": "336-765-0960",
            "fax_number": "336-765-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 SOUTH HAWTHORNE RD",
            "address_2": "SUMMIT EYE CARE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034016",
            "telephone_number": "336-765-0960",
            "fax_number": "336-765-7453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHEMSARA",
        "first_name": "VICKAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "01566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10584171",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST LICENSE",
            "identifier": "01566",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910540",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amit Khanal, MD
• Rupesh Khanal, MD
• Ashish Kumar Khanna, M.D.
• Omaditya Khanna, M.D.
• Sanabil Manzoor Khattak, DDS
• Maroon B Khoury, MD
• David Andrew Kibler, OT/L, CHT
• Hannah Greene Kibler, PA-C
• Domiziana Kidd, PA-C
• Charles Noel Kidroske, DDS

• Ophthalmology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.